Combination Therapy with Hyperthermia, Low-dose Anti-cancer Drug Therapy, and Intravesical Bacillus Calmette–Guérin Instillation for High-risk Non-muscular Invasive Bladder Cancer: A Case of Long-term Survival

Abstract

Introduction: We report a case of long-term survival in a patient with high-risk non-muscular invasive bladder cancer(NMIBC) treated with hyperthermia and low-dose anti-cancer drug therapy combined with intravesical bacillus Calmette–Guérin (BCG) instillation.

Methods:The patient was a male in his 70s. He underwent a left nephroureterectomy for left renal pelvic cancer. Six months later, right renal pelvic cancer was detected. The patient was treated with hyperthermia, radiation therapy, and low-dose anti-cancer drug therapy because he declined surgical treatment. Four years later, he underwent transurethral resection (TUR) of bladder cancer (pathology: urothelial carcinoma (UC) pT1 grade (G) 3) due to recurrence in the bladder. Intravesical instillation of anti-cancer drugs. Next, TUR for urethral recurrence and random bladder biopsy were performed. The pathological diagnosis was UC pT1 G3, and extensive in situ was detected in the bladder. The intravesical instillation of BCG and TUR was conducted four times for urethral recurrence.

Result: During these episodes, the patient refused surgery, and he has been aliving without disturbing his quality of life.

Conclusion: Hyperthermia and low-dose anti-cancer drug treatment combing with intravesical BCG instillation for high-risk non-muscular invasive bladder cancer is effective for the patient refusing standard treatment.